We live in a capitalist economy. Under our system, access to wealth determines much about how we live our lives.

I’m OK with the capitalist system of wealth distribution defining how much house I can afford. Or whether I drive a Chevy or a Lexus. Or whether I can vacation in Europe or Gatlinburg — if at all.

That’s our system, and it mostly works. None of those things are essential to happiness.

On the other hand, we don’t ask individuals to bear the cost of services considered vital — things such as police and fire protection, use of public streets and highways, and basic education.

We do this because we recognize the inequity of shutting out those who are less able to pay for such services.

But what about health?

As one of the main components of human thriving and happiness, isn’t good health critical?

Should our founders have included access to universal health care as a fundamental right of all Americans?

More than two centuries ago, the authors of our foundational documents laid out rights that they deemed “self-evident”: life, liberty and the pursuit of happiness.

They further spelled out many of these rights specifically: the right to freedom of expression, of peaceable assembly, of religious practice, and so forth.

They understood one of the principal functions of government is to ensure everyone has a fair shot at happiness. (Their definition of “everyone” fell far short of the ideal, but that’s a topic for another day.)

It may be hard to imagine, but the health care industry is something that did not exist in the 18th-Century world of our founders.

Our current system of medicine would not be at all recognizable to them.

At least two significant changes have transformed health care since the time of our nation’s founding.

The first involved the efficacy of medical care. In the late 1700s, if you went to a doctor for treatment of virtually any malady, you were as likely to be harmed as helped.

Many scholars believe when George Washington fell ill Dec. 12, 1799, the three leading doctors who attended to him at his home essentially finished him off. Among other things, draining five pints of his blood certainly did Washington no favors. Our first president died two days later.

Washington probably had the flu or possibly even pneumonia, both ailments he may have survived if he had just been left alone.

More to the point, modern medicine can properly diagnose, treat and reduce the severity and duration of these and other illnesses that killed people in Washington’s day.

We have extended human lifespans by decades since then, virtually eliminated fatal childhood illnesses and improved the quality of life for nearly everyone with access to the system.

Access to the system is what brings us to the second significant change. It is just as dramatic as the first but in a negative way.

In Washington’s day, any conceivable treatment would scarcely cost more than an hour or two of labor for the average worker. In many areas, one could pay the local doctor through barter in eggs, flour or meat from their farm.

They could not envision a day when health care would be among the most expensive things Americans would be asked to pay for.

No one expected it to become something that would drive countless numbers into bankruptcy — and shut many more out entirely.

So over the last two centuries, health care in America has grown from something of an inexpensive “optional” service that may have helped or harmed a few people, to an essential one that benefits nearly everyone.

Much like the other freedoms granted to us by our founders, medical care can be said today to be crucial to life, liberty and the pursuit of happiness.

I firmly believe if the founders had been able to foresee this situation, “free or affordable health care for all” would have made their list of guaranteed rights.

Today, every industrialized democratic nation in the world provides its citizens with free or inexpensive universal health care — all, that is, except the United States. The list includes all of Europe, Canada, Australia, Argentina, Brazil, Mexico, Japan and others.

In the depression era, President Franklin D. Roosevelt attempted to add universal health care to his many social reforms but was unsuccessful. Other presidents since Roosevelt have tried, but none succeeded.

It’s past time for the U.S. to join the other world democracies and take steps to make health care free for everyone.

Final thought: Some people slam universal health care as “socialism.” I don’t know if that’s a fair label or not, and I don’t particularly care. But I know it is an equitable and reasonable thing to do and is entirely compatible with the founders’ notion of what a free liberal democracy should be.

Pete Koutoulas is an IT professional working in Lexington. He and his wife have resided in Winchester since 2015. Pete can be reached at pete@koutoulas.me or follow him on Twitter @PeteKoutoulas.